基于数据驱动方法的海马体静息态功能连接预测个体创伤后应激障碍症状
Hippocampal Resting-State Functional Connectivity Forecasts Individual Posttraumatic Stress Disorder Symptoms: A Data-Driven Approach.
机构信息
Department of Psychology, Marquette University, Milwaukee, Wisconsin.
Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin.
出版信息
Biol Psychiatry Cogn Neurosci Neuroimaging. 2022 Feb;7(2):139-149. doi: 10.1016/j.bpsc.2021.08.007. Epub 2021 Sep 1.
BACKGROUND
Posttraumatic stress disorder (PTSD) is a debilitating disorder, and there is no current accurate prediction of who develops it after trauma. Neurobiologically, individuals with chronic PTSD exhibit aberrant resting-state functional connectivity (rsFC) between the hippocampus and other brain regions (e.g., amygdala, prefrontal cortex, posterior cingulate), and these aberrations correlate with severity of illness. Previous small-scale research (n < 25) has also shown that hippocampal rsFC measured acutely after trauma is predictive of future severity using a region-of-interest-based approach. While this is a promising biomarker, to date, no study has used a data-driven approach to test whole-brain hippocampal FC patterns in forecasting the development of PTSD symptoms.
METHODS
A total of 98 adults at risk of PTSD were recruited from the emergency department after traumatic injury and completed resting-state functional magnetic resonance imaging (8 min) within 1 month; 6 months later, they completed the Clinician-Administered PTSD Scale for DSM-5 for assessment of PTSD symptom severity. Whole-brain rsFC values with bilateral hippocampi were extracted (using CONN) and used in a machine learning kernel ridge regression analysis (PRoNTo); a k-folds (k = 10) and 70/30 testing versus training split approach were used for cross-validation (1000 iterations to bootstrap confidence intervals for significance values).
RESULTS
Acute hippocampal rsFC significantly predicted Clinician-Administered PTSD Scale for DSM-5 scores at 6 months (r = 0.30, p = .006; mean squared error = 120.58, p = .006; R = 0.09, p = .025). In post hoc analyses, hippocampal rsFC remained significant after controlling for demographics, PTSD symptoms at baseline, and depression, anxiety, and stress severity at 6 months (B = 0.59, SE = 0.20, p = .003).
CONCLUSIONS
Findings suggest that functional connectivity of the hippocampus across the brain acutely after traumatic injury is associated with prospective PTSD symptom severity.
背景
创伤后应激障碍（PTSD）是一种使人虚弱的疾病，目前尚无准确预测谁会在创伤后患上这种疾病的方法。从神经生物学角度来看，患有慢性 PTSD 的个体在海马体和其他大脑区域（如杏仁核、前额叶皮层、后扣带回）之间表现出异常的静息态功能连接（rsFC），并且这些异常与疾病的严重程度相关。以前的小规模研究（n<25）还表明，使用基于感兴趣区域的方法，创伤后急性测量的海马体 rsFC 可预测未来的严重程度。虽然这是一种很有前途的生物标志物，但迄今为止，还没有研究使用数据驱动的方法来测试全脑海马体 FC 模式，以预测 PTSD 症状的发展。
方法
共有 98 名有 PTSD 风险的成年人在创伤后从急诊室招募，并在 1 个月内完成静息态功能磁共振成像（8 分钟）；6 个月后，他们完成了用于评估 PTSD 症状严重程度的 DSM-5 临床医生管理 PTSD 量表。使用 CONN 提取双侧海马体的全脑 rsFC 值，并在机器学习核脊回归分析（PRoNTo）中使用；使用 k-折交叉验证（k=10）和 70/30 测试与训练分割方法（进行 1000 次迭代以引导置信区间以确定显著性值）。
结果
急性海马体 rsFC 显著预测了 6 个月时的 DSM-5 临床医生管理 PTSD 量表评分（r=0.30，p=0.006；均方误差=120.58，p=0.006；R=0.09，p=0.025）。在事后分析中，在控制人口统计学、基线时的 PTSD 症状以及 6 个月时的抑郁、焦虑和压力严重程度后，海马体 rsFC 仍然显著（B=0.59，SE=0.20，p=0.003）。
结论
研究结果表明，创伤后急性时大脑中海马体的功能连接与前瞻性 PTSD 症状严重程度有关。
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